Bruising debate awaits health bill in Senate

Legislation moves to floor after Thanksgiving as Dems overcome key hurdle Associated Press updated 7:17 am ET, Sun. Nov. 22, 2009

Senate Majority Leader Harry Reid, D-Nev., speaks Saturday after the U.S. Senate voted to begin debate on health care legislation on Capitol Hill in Washington. Sen. Chris Dodd, D-Conn., right, and Sen. Tom Harkin, D-Iowa, look on. photo by Jose Luis Magana/AP WASHINGTON - A bruising debate on health care awaits the Senate after Thanksgiving now that the historic legislation has cleared a key hurdle over the opposition of Republicans eager to inflict a punishing defeat on President Barack Obama. The bill would extend coverage to roughly 31 million who lack it, crack down on insurance company practices that deny or dilute benefits and curtail the growth of spending on medical care nationally. In the final minutes of a daylong session, Majority Leader Harry Reid, D-Nev., accused Republicans on Saturday of trying to stifle a historic debate the nation needed. GOP warns of ‘unsustainable debt’ The Republican leader, Sen. Mitch McConnell of Kentucky, said the vote was anything but procedural — casting it as a referendum on the bill itself, which he said would raise taxes, cut Medicare and create a "massive and unsustainable debt." Two final Democratic holdouts, Sens. Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, announced they would join in clearing the way for a full debate. "It is clear to me that doing nothing is not an option," said Landrieu, who won $100 million in the legislation to help her state pay the costs of health care for the poor. Landrieu and Lincoln, who faces a tough re-election next year, both stressed they were not committing in advance to vote for the legislation that ultimately emerges from next month's debate. Of particular contentiousness to moderates is a provision for the government to sell insurance in competition with private companies, subject to state approval — a part of Reid's bill expected to come under significant pressure as the debate unfolds. Positive response from White House White House press secretary Robert Gibbs said the president was gratified by the vote, which he says "brings us one step closer to ending insurance company abuses, reining in spiraling health care costs, providing stability and security to those with health insurance, and extending quality health coverage to those who lack it." Vice President Joe Biden told Iowa Democrats that the Senate handed the president a big victory with its decision. "Tonight we have more momentum than we've ever had in the history of health care discussions,'" Biden told about 1,000 Democrats in Des Moines. "I see the special interests raising tens of millions of dollars, hundreds of millions of dollars to defeat our agenda," Biden said. "We've never thought change would be easy. You all knew change would be hard. It's hard to change the direction of a nation that's been adrift for at least eight years." The legislation would require most Americans to carry insurance and provide subsidies to those who couldn't afford it. Large companies could incur costs if they did not provide coverage to their workforce. The insurance industry would come under significant new regulation under the bill, which would first ease and then ban the practice of denying coverage on the basis of pre-existing medical conditions. Congressional budget analysts put the legislation's cost at $979 billion over a decade and said it would reduce deficits over the same period while extending coverage to 94 percent of the eligible population. Kennedy’s legacy figures prominently Memories of the late Sen. Edward M. Kennedy, a long-time proponent of health care, figured prominently Saturday night. Sen. Paul Kirk of Massachusetts, appointed to office this fall after Kennedy's death, said he spoke for those "who for so many years revered and loved and elected and re-elected" him. Sen. Chris Dodd of Conn. referred to Kennedy's "lifelong quest" for national health care and said "we will pay him the highest compliment by fulfilling that" goal. Reid said he had talked with Kennedy's widow, Vicki, about the vote and they both agreed "Ted would be happy." © 2009 The Associated Press. All rights reserved.

Moderate Dems wooed in crucial health vote

Key lawmaker annouces he'll vote Saturday to begin debate on the bill Associated Press updated 9:20 p.m. ET, Nov. 20, 2009 WASHINGTON - Suitably opaque, Section 2006 takes up only a few dozen lines in a sweeping health care bill that runs to 2,074 pages and mentions neither Sen. Mary Landrieu nor her state of Louisiana. But the section's purpose is indisputable: to deliver $100 million or more in federal funds to the state. And in the process it could clear the way for one of three moderate Democratic fence-sitters — Ben Nelson of Nebraska and Blanche Lincoln of Arkansas are the others — to help propel the legislation past its initial hurdle in a crucial Saturday vote. Nelson, Landrieu and Lincoln emerged several days ago as the last public holdouts among 58 Democrats and two independents whose votes Majority Leader Harry Reid and the White House must have to overcome the Republicans' attempt to strangle the bill before serious debate can begin. Each has moved carefully with an eye on home-state voters. And inside the Senate, each has taken advantage of the political leverage newly available. Alone among the three, Nelson issued a statement Friday ending any lingering public suspense about his intentions. "The Senate should start trying to fix a health care system that costs too much and delivers too little for Nebraskans," he said, adding his decision should not be seen as an indication of how he will vote on the legislation itself. Nelson had been publicly signaling his intentions for more than a week, and his words presumably came as no surprise to Reid or the White House, which issued a statement Friday saying the bill "provides the necessary health reforms that the administration seeks." Currying votes This sort of political minuet can be delicate, as shown when the Senate's second-ranking Democrat, Dick Durbin of Illinois, said earlier on Friday that Lincoln had already confided to Reid how she planned to vote. Republicans, eager to scuttle the bill — and defeat Lincoln in 2010 — instantly accused the two-term senator of telling Democratic party leaders before informing her own constituents in Arkansas. "No other senator speaks for Senator Lincoln. She is still reviewing the bill," declared the senator's spokeswoman, Leah Vest DiPietro, adding her boss had not yet made up her mind. For his part, Durbin sought to quickly close the loop with a statement saying he had been unclear and misinterpreted. As for Nelson, several officials, speaking on condition of anonymity, said he had insisted Reid omit from the bill any change in the insurance industry's protection from federal antitrust law. The House version of the legislation would expose the industry to scrutiny by both the Justice Department's antitrust lawyers and the Federal Trade Commission. Reid, who spoke out strongly in favor of the change in antitrust treatment earlier in the fall, left it out of the bill he drafted over several weeks and unveiled on Wednesday. Eyes on Lincoln Lincoln has been the most close-mouthed about her intention. As a committee chairman, she is the most powerful of the group. As the only one of the three seeking re-election next year, she is also the most politically vulnerable. In public, she has asked that the bill be available for 72 hours before the vote occurs. In private, her demands have been more substantive, according to officials who did not describe them. She is virtually certain to be criticized no matter what her vote. After the House cleared its version of the legislation this month, a conservative group began airing commercials criticizing Rep. Vic Snyder, D-Ark., for voting in its favor. At the same time, MoveOn.org, a liberal organization, slammed another one of the state's lawmakers, Rep. Mike Ross, for opposing it. A hint: At home, Lincoln has suggested her vote will be influenced by former President Bill Clinton, who was Arkansas governor for 12 years before winning the White House. Clinton recently met privately with Senate Democrats, telling them that passing an imperfect bill was better than nothing. "We don't ever go to Washington with the idea that we're going to create a work of art," Lincoln said afterward. "It's got to be a work in progress." She and the other moderates face pressure from business groups opposed to the legislation. In a statement Friday the Business Roundtable, which represents big company CEOs, said the Senate bill "will not effect the needed changes to measurably improve the American health care system." Democrats and the White House had seized on a report by the same group last week concluding that some of the provisions under consideration by Congress had the potential to tame runaway medical inflation. Section 2006 for Landrieu? Of the three centrists, Landrieu has been the clearest about her intentions, and her interests ranged beyond health insurance to the oysters for which Louisiana is famous. When the Food and Drug Administration proposed banning sales of raw oysters from the Gulf of Mexico during warm weather months, Landrieu and others objected. A week ago, the agency thought better of the idea and shelved the plan in favor of further study. "I'm really thankful that they listened," said Landrieu, who had met with FDA Commissioner Margaret Hamburg to discuss the issue. Over recent weeks, Landrieu has issued a string of statements outlining the areas she wanted addressed for the benefit of her constituents — issues that could be dealt with only after health legislation made it to the Senate floor. After meeting with Reid almost a month ago, she mentioned the "unique challenges Louisiana is facing in terms of Medicaid." In a Senate speech and statement, she noted that Louisiana has the highest breast cancer death rate in the country and the lowest female life expectancy of any state. And she said, "Unless something is done, annual health care costs for small firms over the next 10 years are expected to more than double to reach $339 billion in 2018." Landrieu can point to provisions in the legislation that are designed to attack all three problems. They include Section 2006. Reading it is of little assistance. "Special adjustment to FMAP Determination for Certain States recovering from a Major Disaster" is the title, and about two pages of similarly indecipherable legalese follows. According to the Congressional Budget Office, it will send an additional $100 million to Louisiana to help it cover costs for Medicaid, the federal-state health care program for the poor. Should Landrieu decide to side with Republicans this weekend, she would also be voting to deny her state those funds. Copyright 2009 The Associated Press. All rights reserved.

Democrats have 60 votes to advance health bill

Two remaining Dem holdouts announce they will vote 'yes' to begin debate Associated Press updated 23 minutes ago WASHINGTON - Democratic leaders secured the last votes needed to move ahead on historic health care reform legislation, clearing the way for a Saturday night showdown on President Barack Obama's top domestic policy initiative. In long-awaited speeches, two centrist Democratic senators said they would stand with their party and vote "yes" on the crucial test procedural vote despite deep reservations with parts of the 2,074-page bill to remake the U.S. health care system. "The truth is this issue is very complex. There is no easy fix and it's imperative that we build on what's already working in health care in America," Sen. Blanche Lincoln of Arkansas told her Senate colleagues. Earlier, Sen. Mary Landrieu of Louisiana said she would vote "yes" on the procedural vote to determine whether debate can go forward on the Senate floor on Majority Leader Harry Reid's health care reform bill. Democratic leaders were optimistic they now have the 60 votes needed in the 100-member Senate to go forward. The Senate's 40 Republicans are unanimously opposed. "I've decided that there are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done," Landrieu said, with the 8 p.m. EST (0100 GMT) vote looming. But the two moderate Democrats both cautioned that while they have agreed to allow debate to continue, their vote Saturday does not commit them to supporting the final bill. At a 10-year cost approaching $1 trillion, Reid's legislation is designed to extend coverage to roughly 31 million who lack it, crack down on insurance company practices that deny benefits to people with preexisting medical conditions, and curtail the growth of spending on medical care nationally. Almost everyone would be required to purchase insurance, and billions in new taxes would be levied on insurers and high-income Americans to help extend coverage. During Saturday's debate on the bill, Democrats called a revamp of the nation's health care system long overdue. The U.S. is the only major developed country that does not provide comprehensive medical coverage for its people, and Obama campaigned on a promise to change that. "The country suffers when there is a failure to act on serious challenges that millions of ordinary Americans face in their daily lives," Sen. Patrick Leahy, a Vermont Democrat, said during the rare weekend session. United in opposition, Republicans cast the bill as a costly government takeover of the health care system, built on budget gimmicks. "Move over, Bernie Madoff. Tip your hat to a trillion-dollar scam," said Sen. Kit Bond of Missouri, referring to the mastermind of a multibillion-dollar Ponzi scheme. The action in the Senate comes two weeks after the House of Representatives approved a health overhaul bill of its own on a 220-215 vote. Major health care reform legislation has now advanced further through Congress than at any time since the 1960s when the government-run Medicare health insurance program for seniors was enacted. After the vote Saturday night, senators will leave for a Thanksgiving holiday recess. Upon their return, assuming Democrats prevail on Saturday's vote, they will launch into weeks or more of unpredictable debate on the health care bill, with numerous amendments expected from both sides of the aisle and more 60-vote hurdles along the way. Democratic centrists from conservative states are particularly wary of provisions to have a government-run plan compete with private insurers to drive down coverage costs. Efforts to insert stricter language to bar federal funds from being used to cover abortions has also become a divisive issue. Senate leaders hope to pass their bill by the end of the year. If that happens, January would bring work to reconcile the House and Senate versions. If a compromise can be reached, it would then have to be approved by both chambers of Congress before a final package could land on Obama's desk to sign. The House and Senate bills have many similarities, including the new requirements on insurers and the creation of new purchasing marketplaces called exchanges where self-employed individuals and small businesses could go to shop for and compare coverage plans. One option in the exchanges would be a new government-offered plan, something that's opposed by private insurers and business groups. Differences include requirements for employers. The House bill would require medium and large businesses to cover their employees, while the Senate bill would not require them to offer coverage but would make them pay a fee if the government ends up subsidizing employees' coverage. Another difference is in how they're paid for. The Senate bill includes a tax on high-value insurance policies that's not part of the House bill, while the House would levy a new income tax on upper-income Americans that's not in the Senate measure. The Senate measure also raises the Medicare payroll tax on income above $200,000 annually for individuals and $250,000 for couples. Both bills rely on more than $400 billion in cuts to Medicare. Copyright 2009 The Associated Press. All rights reserved.

Uninsured ER patients twice as likely to die

New study highlights disparity of care for those who don't have coverage Associated Press updated 4:00 p.m. ET, Mon., Nov . 16, 2009 CHICAGO - Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study. The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable. "This is another drop in a sea of evidence that the uninsured fare much worse in their health in the United States," said senior author Dr. Atul Gawande, a Harvard surgeon and medical journalist. The study, appearing in the November issue of Archives of Surgery, comes as Congress is debating the expansion of health insurance coverage to millions more Americans. It could add fodder to that debate. The researchers couldn't pin down the reasons behind the differences they found. The uninsured might experience more delays being transferred from hospital to hospital. Or they might get different care. Or they could have more trouble communicating with doctors. The hospitals that treat them also could have fewer resources. "Those hospitals tend to be financially strapped, not have the same level of staffing, not have the same level of surgeons and testing and equipment," Gawande said. "That also is likely a major contributor." Gawande favors health care reform and has frequently written about the inequities of the current system. The researchers took into account the severity of the injuries and the patients' race, gender and age. After those adjustments, they still found the uninsured were 80 percent more likely to die than those with insurance — even low-income patients insured by the government's Medicaid program. "I'm really surprised," said Dr. Eric Lavonas of the American College of Emergency Physicians and a doctor at Denver Health Medical Center. "It's well known that people without health insurance don't get the same quality of health care in this country, but I would have thought that this group of patients would be the least vulnerable." Private hospitals more likely to transfer uninsured Some private hospitals are more likely to transfer an uninsured patient than an insured patient, said Lavonas, who wasn't involved in the new research. "Sometimes we get patients transferred and we suspect they're being transferred because of payment issues," he said. "The transferring physician says, 'We're not able to handle this."' Federal law requires hospital ERs to treat all patients who are medically unstable. But hospitals can transfer patients, or send them away, once they're stabilized. A transfer could worsen a patient's condition by delaying treatment. The researchers analyzed data on nearly 690,000 U.S. patients from 2002 through 2006. Burn patients were not included, nor were people who were treated and released, or dead on arrival. In the study, the overall death rate was 4.7 percent, so most emergency room patients survived their injuries. The commercially insured patients had a death rate of 3.3 percent. The uninsured patients' death rate was 5.7 percent. Those rates were before the adjustments for other risk factors. The findings are based on an analysis of data from the National Trauma Data Bank, which includes more than 900 U.S. hospitals. "We have to take the findings very seriously," said lead author Dr. Heather Rosen, a surgery resident at Los Angeles County Hospital, who found similar results when she analyzed children's trauma data for an earlier study. "This affects every person, of every age, of every race." © 2009 The Associated Press. All rights reserved.

Milbridge Healthcare Workers In Search Of New Contract

by Rob Poindexter · Nov 16th 2009 WABI-TV 5 Workers at a healthcare facility in Milbridge say their being treated unfairly by ownership and they've decided to let their voices be heard. They've decided to take their frustration to the streets. LaVerne Coopersmith, a CNA at the facility, says their demands are not that unreasonable. "Maybe a 2% raise and a signed contract, that doesn't seem like asking too much, it seems fair," she says. The workers say management got a pay raise and they want what they say is fair. Dr. Stephen Weisberger is the owner of the facility and he told TV5 the following over the phone. "To my knowledge, no raises have been given to any administrator or manager since the wage freeze. These are tough times. My workers are fantastic and we're working towards a solution that is financially viable for them." Workers claim management received their pay increases just a month before their own wages were frozen and they say that isn't right. "We realize the economy is bad," says Marie Leighton a CRMA at the facility, "but I guess if management hadn't gotten theirs, it wouldn't have been so bad, but they got theirs in April and we got a freeze in May and I don't think that's quite fair." Patients and their families say the staff here works hard and deserves fair treatment. Jackie Jellison's mother is being treated in the Narraguagus Healthcare Facility and she says the care there is first rate. "The care that these ladies have for these residents is wonderful. I mean they go out of their way and like Marie said, they stop in on their off time to see how patients are." The protestors say they will continue to picket as long as it takes. The two sides are scheduled to sit down at the negotiating table on December 4th. Video for this story is available through this link.

Local 771 - November 21, 2009 Agenda

MSEA-SEIU Local 1989 Local 771 Chapter Meeting November 21, 2009, 10 am to Noon

MSEA Headquarters, 65 State Street, Augusta, Maine

10:00 Welcome Introductions 10:05 Review Minutes from October meeting 10:10 Treasurer’s Report 10:15 Membership Update 10:20 771 Election of 2010 Officers 10:50 MSEA-SEIU Annual Convention Disaffiliation with SEIU 11:00 771 By-Laws: Elections 11:10 Legislative Update Long-Term Care System LEAN Process Worker Taskforce Group, Monday, 11/30, 1pm DHHS 11:25 Bargaining Alpha One 11:40 KVO Annual Fundraising Campaign 771 wish to make a donation? 11:50 Downeast Federation of Nurses & Health Professionals Local 5073 Narraguagus Bay Health Care Facility Picket 11:55 Next Steps Next Local 771 Meeting _________________________ 12:00 Adjourn Be sure to check out your Local’s blog: http://www.unionmaine771news.blogspot.com/. If you need to contact me, Helen Hanson, helen.hnsn@gmail.com.

Minutes October 24, 2009 Meeting

LOCAL 771 CHAPTER MEETING 10/24/2009 MINUTES Attendance: Members: Helen Hanson, Joe Berry, Ted Rippy, Juanita Burtt, Roxann Gargac, Dixie Lewis, Dee Dee Strout Local 771 Field Rep: CJ Betit Local 771 Organizers: Jay Economy MSEA-SEIU Retiree: Phil Wolley MSEA-SEIU 1989 President: Bruce Hodgdon Review of Minutes of 9/19/09 Chapter Meeting Helen Hanson distributed the minutes of the 9/19/09 Chapter Meeting and they were reviewed and accepted. The one change to the minutes was in the Alpha One Bargaining Update that Dennis Fitzgibbons had not been present at the 9/10/09 meeting. National Direct Care Partnership & Voices Institute Local 771 members Ted Rippy and Dee Dee Strout reported on their attendance at the Voices Institute for leadership training in Wisconsin during the week of September 27th.Ted and Dee Dee both reported that this was an invaluable experience in learning how to lobby for change. The Direct Care Alliance is working hard to professionalize the DCW field, and DCW’s from 16 different states were in attendance. Ted and Dee Dee said they saw a lot of change and growth during the week, and very much appreciated the scholarships from MSEASEIU. Ted and Dee Dee will report back to MSEASEIU’s Board of Directors in November regarding their experiences at the Voices Institute. Treasurer’s Report In Pat Crowell’s absence, Helen Hanson reported Local 771 currently has $896.61 in it’s savings account and $105.57 in it’s checking account. LD 1078 Update Helen Hanson reported that the DHHS Lean Study of the long term care system is well under way. There are 18 members on the core committee ( including Helen) , and that Dee Dee Strout, Ted Rippy, and Helen will also be working on the Worker’s Committee which begins meeting on Oct. 26, 2009. Helen related that the study seems to be showing that the system is too top heavy administratively and that the clearing house agency of Elder Independence of Me ( EIM) is being looked at very closely. MSEA-SEIU 1989 Convention 2009 Local 771’s delegates for convention will be Helen Hanson, Joe Berry, Ted Rippy, Sherri Rippy, Dave Levasseur, Carol Ann Cammack, and Dixie Lewis. Carol Ann was elected as a delegate at an emergency chapter meeting held at the Area One Caucus on October 3, 2009. There was a general discussion of the upcoming convention and President Hodgdon reviewed resolutions that were currently scheduled to be raised at convention, including a resolution to consider disaffiliation from SEIU. Local 771 is strongly opposes this disaffiliation resolution, as SEIU has been a strong advocate for health care workers and many of our members take advantage of the health and dental insurance plans offered by SEIU. Pre-Retirement Planning Retiree Phil Wooley gave a presentation on the importance of pre-retirement planning, and reviewed the pre-retirement committee’s training provided to state employees. He emphasized that everyone’s retirement is different and you can not begin planning too early. Phil distributed a survey for members to complete and return. Alpha One Bargaining Update Field Rep CJ Betit reported that the one remaining issue to be resolved in the new A1 contract is the decision of when the closed shop status will go into effect. This issue should be resolved shortly. Labor Management Committee Dixie Lewis and Carol Ann Cammack will serve on the HC4M Labor Management Committee with CJ Betit. Issues to be discussed include scheduling and fill-ins. HC4M has told CJ that if a DCW calls in for a fill in the worker will not get a call back unless they cannot fill the request. This is something DCW’s had not been aware of and expecting and not getting a call back has been very frustrating. CJ reported that on he had received some good news in that HC4M has been over budget in hours of service delivered in July 1491-1403, August 1543-1403 and September 1554-1403. Next Meeting November 21, 2009 , 10AM – Noon at MSEA Headquarters in Augusta. Coffee and refreshments will be provided. Chapter elections for officers and delegates will be held at this meeting.